The Social Security Administration uses a five step sequential evaluation, the five step sequential evaluation asks whether or not you have engaged in gainful activity, whether you have a severe impairment, meet a listing, whether you can return to the work that you did in the past and whether you are capable of performing other work in the national economy based on your age, education and transferable skills.

On the other hand, each long term disability policy has their own definition of disability that generally the

definition of disability

definition is the inability to engage in the material and substantial duties of your occupation.

The definitions are not the same.

In the Social Security determination, advancing age is factor in determining whether to award benefits and it treats advancing age as a limiting factor in ability to adjust to the work. On the other hand, long term disability carriers do not use age in assessing whether or not a policy holder meets its definition of disability. If your disability benefits have been delayed or denied, call long term disability attorney Nancy Cavey today at 727.894.3188 no obligation consultation.

What’s the two step ERISA claim’s process?

Under ERISA, you have the right to file a claim for disability benefits and provide a disability carrier with information about your claim.

If your plan administration denies your claim, you have 180 days to appeal. That can make all the difference between getting and losing your ERISA benefits.

You must complete the appeal before filing a lawsuit. If your ERISA long term disability claim is denied, contact disability attorney Nancy Cavey who can explain to you your rights to long term disability benefits. Do not wait to learn about your options, contact us today before your disability claim is denied.

How much of my income is disability insurance intended to replace?

Many Americans, just like Nancy Cavey’s father, purchased disability insurance to provide financial assistance when they need it most and were disabled and unable to work. Disability insurance benefits are intended to replace from 40-60% of your gross income if you are unable to work for an extended period of time.

If you are looking to file for disability, or looking to answer questions about disability like is your income on disability insurance going to replace your current income, give us a call today at 727-894-3188 to talk with us. The call is free, and the questions answered can help your disability claim.

What are the common medical conditions that may entitle you to long term disability benefits?

If you purchased a long term disability policy from your employer or purchased a policy individually, you may be entitled to disability benefits if you suffered from one or more of the following medical conditions:

- Bipolar Disorder: Bipolar Disorder is also known as Manic Depressive Disorder and it can lead to crippling mood swings, irrational behavior and even suicidal tendencies.

- Anxiety Disability: Anxiety can cause sudden bouts of intense fear or anxiety. You can have symptoms including pounding heart, shortness of breath, feeling of losing control, or even denial.

- Schizophrenia: Schizophrenia is a mental disorder characterized by a disassociation of sensory input, feelings and emotions on one hand and thoughts on the other. You can have hallucinations, hearing voices or even feeling that your thoughts or actions are under someone else’s control.

If you or a family member suffer from any of these psychiatric conditions and your claim for long term disability benefits is denied, contact long term disability denial attorney Nancy Cavey who can help you get your disability benefits regardless of where you live in the United States.

Before suing a long-term disability carrier, it is advisable to exhaust your appeal rights that are available under the Employee Retirement Income Security Act, (ERISA). If you purchased your group long-term disability policy through your employer, your case will be governed under the ERISA disability law which allows for a 180-day appeal period.

Nancy Cavey, ERISA long-term disability attorney, suggests that you get a copy of the long-term disability carrier’s file, including the adjusting notes, so you can see how they set your claim up for denial. It is important that you retain an experienced ERISA disability attorney to perfect an appeal that addresses point by point, blow by blow, every ground the carrier has raised to wrongfully deny your long-term disability benefits.

They may have had you have an Independent Medical Evaluation, a Functional Capacity Evaluation, or taken your statement in an effort to find a reason to justify their claims denial. There are specific strategies that can be employed to fight denial based on the carrier’s use of an Independent Medical Evaluation or vocational evaluation.

Many times long-term disability carriers will combine your statement with surveillance and try to trap you into admitting that you are capable of working or that you exaggerated your limitations.

Don’t be intimidated by the long-term disability carrier!

Once you have exhausted the 180-day appeal period, you may sue in Federal court if the long-term disability carrier has refused to reinstitute your benefits.

Many long-term disability carriers don’t make it easy to be civil to get the continued benefits you deserve. If a severe medical condition makes it impossible for you to work, and the long-term disability carrier has now denied your benefits after many years of making payments, ERISA disability attorney Nancy Cavey can help cut through the red tape and fight for your benefits, no matter where you live in the United States. Contact her today at 727-894-3188.

How Much Long Term Disability Coverage Should I Have?

The starting point for determining the amount of long term disability coverage that you should have is based on how much it would cost to maintain your families current standard of living. So, if your monthly budget is $3,000 per month, you want to have at least $3,000 in long term disability coverage so that you can maintain your families lifestyle if you become disabled.

Have a question about your Long Term Disability policy or coverage? Give us a call today at 727-894-3188.

Can long term disability Carriers sue me for a refund of my long term disability benefits?

Unfortunately, one of the techniques that long term disability carriers seem to be using these days is to terminate long term disability benefits and then attempt to sue policy holders asking for a refund of benefits. Saying that they were “defrauded” This is just one of the many games that long term disability carriers will play to rob you of your peace of mind.

If the long term disability carrier is seeking a refund of all the long term disability benefits paid, contact long term disability attorney Nancy Cavey.

Can a Long Term Disability Carrier in Florida Take my Social Security Disability Benefits that I Receive in a Lump Sum?

No! In Herman vs. Metropolitan Life Insurance Company (689 f supp 2d 1316 (MD Florida 2010)), Ms. Hermann did not have to pay back Metropolitan Life’s claimed lien resulting in her receipt of Social Security Disability benefits. Ms. Herman had “dissipated” or spent the long term disability benefits that had been paid in the past, she had no traceable funds in her possession. The only recovery that Metropolitan Life could potentially make was from Social Security benefits. However, by law, Social Security Disability benefits are protected from execution or the attachment garnishment or other legal process. However, that’s not the end of the case. Why? While there was no identifiable funds, MetLife could reduce any future long term disability benefits by the receipt of the Social Security Disability benefits. In Ms. Herman’s case, MetLife actually denied her claim for on going disability benefits. They were suing Ms. Herman asking her for a money judgment that would allow MetLife to levy on her general assets. Because the long term disability benefits had been spent, the only funds that Ms. Herman had available to satisfy the judgment was from the monthly Social Security check which judgment proof. Obviously then, the long term disability carrier’s right to reimbursement for the overpayment of Social Security Disability benefits is a complicated one and you should consult long term disability overpayment attorney Nancy Cavey.

FAQ: Why does the long term disability carrier have the right to reduce my long term disability benefits by the receipt of Social Security benefits?

Answer: Great question! Unfortunately, many long term disability carriers have a clause in the insurance contract that says that the long term disability carrier gets to take advantage of your favorable Social Security decision. That means they can ask for a repayment of overpayment of benefits and reduce your future long term disability benefits. They get you coming and going.

Florida long term disability attorney Nancy Cavey, has written Robbed of Your Peace of Mind, which explains the contract terms that you do not want to see in your long term disability policy.

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LEGAL ADVICE DISCLAIMER: The contents of this blog are for educational purposes only and do not constitute legal advice and the information offered does not create an attorney client relationship. If you would like such advice please contact us directly at 727-894-3188 to be considered for acceptance as a client of the firm.